Sleep Deprivation

The number of hours slept within a 24-hour time period is related to reduced ability to accurately and efficiently complete cognitive tasks and increases in problem behaviors (e.g., agitation, daytime drowsiness, or learning problems). Sleep deprivation is most often the result of environmental determinants (e.g., ambient temperature or noisy sleeping environments), organic causes (e.g., craniofacial abnormalities), or health issues (e.g., allergies or seizures). The etiology of sleep deprivation and related sleep problems is a complex interaction of the gene-brain-behavior relation having wide implications for behavior, cognition, and health.

Animal models often are used to analyze the deleterious effects of sleep deprivation on gene-brainbehavior processes. Animal models are necessary to identify the mechanism by which sleep deprivation affects behavior because direct manipulation of sleep in people is not always ethically acceptable. Extended sleep deprivation demonstrates differential effects on behavioral functions implicating a variety of brain structures and related neurotransmitter systems. Consequences of sleep deprivation extend from behavioral adaptation to changes in sensory systems (e.g., pain sensation). Moderate levels of rapid eye movement sleep deprivation (REMSD) suppresses appetitive behaviors, suggesting that sleep-deprived animals may choose to sleep rather than engage in behavior, even behaviors paired with unconditioned reinforcement (e.g., food). Conversely, moderate sleep deprivation produces increased rates of negatively reinforced behavior. The differential effects of sleep deprivation, as it relates to behavioral function, lend themselves well to behavioral changes observed in applied settings. That is, behaviors paired with negative reinforcement (e.g., self-injury that results in the removal of a demand) often increase in the hours or days following sleep deprivation, while behaviors paired with obtaining a positive reinforcer (e.g., task completion that is reinforced with praise) decrease. The reasons for these differential effects on behavior may relate to the neural mechanisms of the sensory systems involved. For example, alterations of sensory perceptions have been noted following sleep deprivation. Simply stated, sleep deprivation makes noxious stimuli more noxious.

Sleep problems, most specifically insomnia and sleep apnea, are most prevalent in people with disabilities. Therefore, a discussion of sleep problems encountered by many with disabilities is warranted (although the concepts are equally applicable to people without disabilities). It is interesting that the type of sleep problem may relate to the type of developmental disability (i.e., sleep apnea is more prevalent in people who have Down syndrome, while many people with mental retardation experience insomnia). The direct and indirect effects of sleep problems of people with disabilities are of great concern to families, self-advocates, and support personnel. People with disabilities often do not verbally express the subjective effects of sleep or sleep-related problems. Sleep deprivation also seems to have a synergistic relation to a person's overall health. Undiagnosed health problems, such as seizures, gastrointestinal distress, or sleep disturbances may facilitate or bolster problem behavior impeding the person's quality of life. Medications used to treat health problems may exacerbate behavioral problems or may produce sleep problems as a side effect. Often it is unclear whether health problems lead to problem behavior or problem behavior leads to health problems. It has been suggested that problematic behaviors exhibited by some children diagnosed with ADHD or ADD may be related to sleep problems. In fact, the hallmark hyperactivity exhibited by someone diagnosed with ADHD may be a side effect of sleep problems.

...